Supplemental Material For: Calciphylaxis in Autopsy, A Retrospective Case-Controlled Study of 7 Decedents

This is supplemental material for a small case series "Calciphlaxis in Autopsy, A Retrospective Case-Controlled Study of 7 Decedents", in which autopsy tissue was examined from 7 decedents with a known antemortem history of calciphylaxis. Calciphylaxis is traditionally thought of a primary cutaneous vaascular disease which leads to localized necrosis and often infection with a high mortality rate. There have been case reports and suggestions that calciphylaxis is a systemic disease with findings in other organs. Our goal was to re-examine autopsy tissue histologically from the 7 decedents with a history of calciphylaxis for systemic findings of calciphylaxis. In short, we found vascular calcifications and thromboses in a number of visceral organs including the pancreas, kidney, lungs, and spleen. The findings, while not diagnostic could be supportive of systemic involvement by calciphylaxis. This could be a reason why some patients with calciphylaxis, along with superimposed infection, have a high mortality rate and succumb to their disease so quickly. Supplemental Table 1 includes comprehensive clinical and pathologic findings for the 7 decedents in the study. Supplemental Figure 1 demonstrates histologic findings from different organs which highlight pathologic vascular findings which could be attributed to calciphylaxis.